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de Filippis R, Viola P, Pisani D, Chiarella G, De Fazio P, Segura-Garcia C. Palatal myoclonus with tinnitus treated as a psychogenic disorder for 35-years. Encephale 2023; 49:196-197. [PMID: 35725518 DOI: 10.1016/j.encep.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/12/2022] [Indexed: 10/18/2022]
Affiliation(s)
- R de Filippis
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - P Viola
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, Catanzaro 88100, Italy
| | - D Pisani
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, Catanzaro 88100, Italy
| | - G Chiarella
- Audiology Unit, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, University "Magna Graecia", Viale Europa, Catanzaro 88100, Italy.
| | - P De Fazio
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
| | - C Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Viale Europa, Catanzaro 88100, Italy
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Young J, Mercieca L, Ceci M, Pisani D, Betts A, Boffa M. A case of bullous pemphigoid after the SARS-CoV-2 mRNA vaccine. J Eur Acad Dermatol Venereol 2022; 36:e13-e16. [PMID: 34547137 PMCID: PMC8661451 DOI: 10.1111/jdv.17676] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/16/2021] [Indexed: 12/16/2022]
Affiliation(s)
- J. Young
- Department of DermatologyMater Dei HospitalMsidaMalta
| | - L. Mercieca
- Department of DermatologyMater Dei HospitalMsidaMalta
| | - M. Ceci
- Department of PathologyMater Dei HospitalMsidaMalta
| | - D. Pisani
- Department of PathologyMater Dei HospitalMsidaMalta
| | - A. Betts
- Department of PathologyMater Dei HospitalMsidaMalta
| | - M.J. Boffa
- Department of DermatologyMater Dei HospitalMsidaMalta
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Borg L, Mercieca L, Mintoff D, Micallef D, Pisani D, Betts A, Scerri L. Pfizer-BioNTech SARS-CoV-2 mRNA vaccine-associated erythema multiforme. J Eur Acad Dermatol Venereol 2022; 36:e22-e24. [PMID: 34547125 DOI: 10.1111/jdv.17682] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- L Borg
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - L Mercieca
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Micallef
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - A Betts
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - L Scerri
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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Magri Gatt P, Mercieca L, Pisani D, Gatt N, Boffa MJ. A recurring blistering eruption on the palms. Clin Exp Dermatol 2021; 47:470-472. [PMID: 34595759 DOI: 10.1111/ced.14918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Affiliation(s)
- P Magri Gatt
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - L Mercieca
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - N Gatt
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - M J Boffa
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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Affiliation(s)
- D Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - A Betts
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - L Scerri
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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Diacinti D, Pisani D, Cipriani C, Celli M, Zambrano A, Diacinti D, Kripa E, Iannacone A, Colangelo L, Nieddu L, Pepe J, Minisola S. Vertebral fracture assessment (VFA) for monitoring vertebral reshaping in children and adolescents with osteogenesis imperfecta treated with intravenous neridronate. Bone 2021; 143:115608. [PMID: 32829035 DOI: 10.1016/j.bone.2020.115608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/21/2020] [Accepted: 08/15/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The study was aimed at monitoring vertebral bodies changes with the use of Vertebral Fracture Assessment (VFA) in children and adolescents affected by osteogenesis imperfecta (OI) during treatment with intravenous neridronate. METHODS 60 children and adolescents (35 males and 25 females; age 1-16 years) with OI type I, III and IV were included in the study. Intravenous neridronate was administered at the dose of 2 mg/kg every 3 months in all patients. Lumbar spine (LS) bone mineral density (BMD) and VFA by dual X-ray absorptiometry (DXA) were assessed every 6 months up to 24 months during treatment. VFA with vertebral morphometry (MXA) was used to calculate the three indices of vertebral deformity: wedging, concavity and crushing. Serum calcium, phosphate, parathyroid hormone (PTH), 25-hydroxy-vitamin D [25(OH)D], total alkaline phosphatase (ALP), bone alkaline phosphatase (BALP) and urinary C-terminal telopeptide of type 1 collagen (CTx) were measured at any time point. RESULTS Mean LS BMD values significantly increased at 24 months compared to baseline (p < 0.0001); the corresponding Z-score values were -1.28 ± 1.23 at 24 months vs -2.46 ± 1.25 at baseline; corresponding mean Bone Mineral Apparent Density (BMAD) values were 0.335 ± 0.206 vs 0.464 ± 0.216. Mean serum levels of ALP, BALP and CTx significantly decreased from baseline to 24 months. By MXA, we observed a significant 19.1% reduction of the mean wedging index of vertebral reshaping at 12 months, and 38.4% at 24 months (p < 0.0001) and of the mean concavity index (16.3% at 12 months and 35.9% at 24 months; p < 0.0001). Vertebral reshaping was achieved for 66/88 (75%) wedge fractures and 59/70 (84%) concave fractures, but there were 4 incident mild fractures. Finally, VF rate was reduced at 24 months compared to baseline: 37/710 (5.2%) vs 158/710 (22.2%). CONCLUSION Our study demonstrates the utility of VFA as a safe and alternative methodology in the follow-up of children and adolescents with OI.
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Affiliation(s)
- D Diacinti
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, viale Regina Elena 324, 00161 Rome, Italy
| | - D Pisani
- Department of Clinical and Molecular Medicine, Saint'Andrea Hospital, Sapienza University of Rome, via Grottarossa, 1035, Rome, Italy
| | - C Cipriani
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161,Rome, Italy.
| | - M Celli
- Department Materno-Infantile, Center of Rare Disease and Skeletal Dysplasia, Policlinico Umberto I Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - A Zambrano
- Department Materno-Infantile, Center of Rare Disease and Skeletal Dysplasia, Policlinico Umberto I Hospital, Viale del Policlinico, 155, 00161 Rome, Italy
| | - D Diacinti
- Department of Oral and Maxillo-Facial Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, via Caserta 6, 00161, Rome, Italy; Department of Diagnostic and Molecular Imaging, Radiology and Radiotherapy, University Foundation Hospital Tor Vergata, Rome, Italy
| | - E Kripa
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, viale Regina Elena 324, 00161 Rome, Italy
| | - A Iannacone
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, viale Regina Elena 324, 00161 Rome, Italy
| | - L Colangelo
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161,Rome, Italy
| | - L Nieddu
- Faculty of Economics, UNINT University, Via Cristoforo Colombo 200, 00147, Rome, Italy
| | - J Pepe
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161,Rome, Italy
| | - S Minisola
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161,Rome, Italy
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Viola P, Scarpa A, Pisani D, Petrolo C, Aragona T, Spadera L, De Luca P, Gioacchini FM, Ralli M, Cassandro E, Cassandro C, Chiarella G. Sub-Clinical Effects of Chronic Noise Exposure on Vestibular System. Transl Med UniSa 2020; 22:19-23. [PMID: 32523903 PMCID: PMC7265918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AIM to investigate the effect of chronic noise exposure on vestibular function of subjects without clinical evidence of vestibular disorders and with documented cochlear damage from noise. SUBJECTS AND METHODS 25 patients with chronic noise-induced hearing loss (NIHL) and without vestibular complaints (group A) and 25 matched controls with sensorineural hearing loss without noise exposure (group B), underwent audiological and vestibular test including caloric and cervical vestibular-evoked myogenic potentials tests (cVEMPs). RESULTS In subjects chronically exposed to noise, similarly to that of the auditory threshold, an increase in the evocation threshold of VEMPs has been documented, statistically significant (p<0,05) and independent of the performance of the auditory threshold. p1-n1 amplitude values showed a significant difference between group A and group B. No significant difference for p1-n1 latencies between the two groups was found. CONCLUSION We have documented the possibility of vestibular lesion, along with cochlear damage, related to chronic acoustic trauma.
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Affiliation(s)
- P Viola
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, University "Magna Graecia", Catanzaro, Italy
| | - A Scarpa
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - D Pisani
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, University "Magna Graecia", Catanzaro, Italy
| | - C Petrolo
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, University "Magna Graecia", Catanzaro, Italy
| | - T Aragona
- Otolaryngology, A.O.U. Ospedali Riuniti, Ancona, Italy
| | - L Spadera
- Otolaryngology, San Leonardo Hospital, Castellammare di Stabia, Napoli, Italy
| | - P De Luca
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - F M Gioacchini
- ENT Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - M Ralli
- Department of Sense Organs, University Sapienza of Rome, Italy
| | - E Cassandro
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - C Cassandro
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - G Chiarella
- Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, University "Magna Graecia", Catanzaro, Italy
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Diacinti D, Pisani D, D'Avanzo M, Celli M, Zambrano A, Stoppo M, Diacinti D, Roggini M, Todde F, D'Eufemia P, Pepe J, Minisola S. Reliability of vertebral fractures assessment (VFA) in children with osteogenesis imperfecta. Calcif Tissue Int 2015; 96:307-12. [PMID: 25694358 DOI: 10.1007/s00223-015-9960-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/29/2015] [Indexed: 10/24/2022]
Abstract
The aim of this study is to evaluate the diagnostic accuracy of vertebral fractures assessment (VFA) in comparison with conventional radiography in identifying vertebral fractures in children and adolescents affected by OI. On 58 patients (33 males, 25 females; age range 1-18 years; 41 children and 17 adolescents) with osteogenesis imperfecta (OI type I, n = 44, OI type III, n = 4; OI type IV, n = 10), lateral spine images by radiographs and by dual-energy X-ray absorptiometry (DXA) were acquired. For vertebral fracture diagnosis, plain radiographs were used as "gold standard" and VFA and morphometric X-ray absorptiometry (MXA) were performed. The visualized vertebrae were 738 (97.9%) by radiographs and 685 (90.9%) by DXA of a total of 754 vertebrae from T4 to L4. VFA and MXA identified, respectively, 129 (74%) and 116 (66%) of the 175 vertebral fractures detected by radiographs. Radiographs identified 36 patients with vertebral fractures, VFA 35 and MXA 41 (6 false positives). On a per vertebra basis, radiographs and VFA had elevated agreement (93.9%; k score 0.81, 95% CI 0.76-0.86), that resulted slightly lower for MXA (90.6%; k score 0.72, 95% CI 0.65-0.78). VFA and MXA demonstrated high sensitivity (95.6 and 94.1 %, respectively) while specificity was 100% for VFA and 90.6% for MXA on a per patient basis; the agreement was excellent for VFA (98.3%; k score 0.96, 95% CI 0.89-1.03) and good for MXA (87.9%; k score 0.73, 95% CI 0.55-0.91). The diagnostic performance parameters resulted better for VFA (sensitivity 95.6%; specificity 100%; PPV 100%; NPV 97.2%), than for MXA (sensitivity 94.1%; specificity 85.4%; PPV 72.7%; NPV 97.2%). The results of our study demonstrate the reliability of VFA for diagnosis of vertebral fractures in children with OI suggesting its use as a more safe and practical alternative to conventional radiography.
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Affiliation(s)
- D Diacinti
- Department of Radiology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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Diacinti D, Guglielmi G, Pisani D, Diacinti D, Argirò R, Serafini C, Romagnoli E, Minisola S, Catalano C, David V. Vertebral morphometry by dual-energy X-ray absorptiometry (DXA) for osteoporotic vertebral fractures assessment (VFA). Radiol Med 2012; 117:1374-85. [PMID: 22744340 DOI: 10.1007/s11547-012-0835-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 03/26/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was done to evaluate the diagnostic accuracy of dual-energy X-ray absorptiometry (DXA) compared with conventional radiography for identifying vertebral fractures. MATERIALS AND METHODS A total of 930 postmenopausal women underwent conventional radiography and DXA imaging of the spine. The images were evaluated by two expert skeletal radiologists using the semiquantitative (SQ) method for conventional radiography and the morphometric vertebral fracture assessment (VFA) for DXA. RESULTS The SQ method for radiography (SQ-Rx) analysed 99.1% of vertebrae, identifying 442 vertebral fractures; VFA analysed 97.5% vertebrae, detecting 420 vertebral fractures. Agreement between SQ-Rx and VFA reached 98.76%, and the κ-score was 0.96 [95% confidence interval (CI), 0.95-0.98]. Assessing the grading of vertebral fractures, agreement reached 97.5% and the κ-score was 0.841 (95% CI, 0.821-0.891). Considering SQ-Rx method as "gold standard", VFA had a sensitivity of 97.85 % and a specificity of 99.81%. The negative (NPV) and positive (PPV) predictive value for VFA were 99.83 % and 98.15%, respectively. Fractures were identified in 251 (27 %) and 242 (26 %) of patients on SQ-Rx and VFA, respectively. On a per-patient basis, the agreement between the two methods was 97% and the κ-score was 0.95 (95% CI, 0.920-0.968). The diagnostic parameters for VFA were 97.23% sensitivity, 98.86% specificity, 97.60% PPV and 98.84% NPV. CONCLUSIONS This study demonstrated that VFA with DXA may reach a high level of accuracy for diagnosing vertebral fractures, suggesting that VFA should be introduced in the screening of individuals with a risk of osteoporosis and in the follow-up of osteoporotic patients receiving treatment.
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Affiliation(s)
- D Diacinti
- Department of Radiology, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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Mohun SM, Davies WL, Bowmaker JK, Pisani D, Himstedt W, Gower DJ, Hunt DM, Wilkinson M. Identification and characterization of visual pigments in caecilians (Amphibia: Gymnophiona), an order of limbless vertebrates with rudimentary eyes. ACTA ACUST UNITED AC 2011; 213:3586-92. [PMID: 20889838 DOI: 10.1242/jeb.045914] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In comparison with the other amphibian orders, the Anura (frogs) and Urodela (salamanders), knowledge of the visual system of the snake-like Gymnophiona (caecilians) is relatively sparse. Most caecilians are fossorial with, as far as is known any surface activity occurring mainly at night. They have relatively small, poorly developed eyes and might be expected to possess detectable changes in the spectral sensitivity of their visual pigments. Microspectrophotometry was used to determine the spectral sensitivities of the photoreceptors in three species of caecilian, Rhinatrema bivittatum, Geotrypetes seraphini and Typhlonectes natans. Only rod opsin visual pigment, which may be associated with scotopic (dim light) vision when accompanied by other 'rod-specific' components of the phototransduction cascade, was found to be present. Opsin sequences were obtained from the eyes of two species of caecilian, Ichthyophis cf. kohtaoensis and T. natans. These rod opsins were regenerated in vitro with 11-cis retinal to give pigments with spectral sensitivity peaks close to 500 nm. No evidence for cone photoreception, associated with diurnal and colour vision, was detected using molecular and physiological methods. Additionally, visual pigments are short-wavelength shifted in terms of the maximum absorption of light when compared with other amphibian lineages.
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Affiliation(s)
- S M Mohun
- UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V9EL, UK
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Diacinti D, Pisani D, Barone-Adesi F, Del Fiacco R, Minisola S, David V, Aliberti G, Mazzuoli GF. A new predictive index for vertebral fractures: the sum of the anterior vertebral body heights. Bone 2010; 46:768-73. [PMID: 19895914 DOI: 10.1016/j.bone.2009.10.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2008] [Revised: 10/13/2009] [Accepted: 10/28/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED Evaluation of osteoporotic vertebral fracture risk is currently based on measurement of bone mineral density (BMD), but bone strength depends also on bone quality parameters. Aim of this study was to evaluate the validity of a new vertebral morphometric index, the Anterior Vertebral Heights sum (AHs) in discriminating women at high risk of vertebral fracture, comparing its diagnostic accuracy with that of BMD measured at lumbar spine (LS-BMD) and femoral neck (FN-BMD). MATERIALS AND METHODS A total of 163 Caucasian post-menopausal women (age range 46-74 years, mean age+/-SD=63.8+/-7.1 years), who did not present prevalent fractures at baseline evaluation, were observed at longitudinal follow-up. X-ray of the thoracic and lumbar spine, LS-BMD and FN-BMD measurements were obtained in all patients at baseline and repeated at the second follow-up visit 18-24 months later (mean 21+/-1.7 months). Radiographs of spine were analysed in order to identify vertebral fractures using a visual semiquantitative method (SQ) and vertebral morphometry as well as by calculating the AHs morphometric index. RESULTS During follow-up, 21/163 patients (12.9%) sustained a new vertebral fracture; 95.2% (20/21) of fractured patients but only 4.9% (7/142) of non-fractured women had reduced AHs values. As regarding BMD, 66.6% (14/21) and 61.9% (13/21) of women with incident fracture were osteoporotic at lumbar spine and femoral neck baseline evaluation , whereas among non-fractured women, 38% (54/142) at LS-BMD and 33.1% (47/142) at FN-BMD were osteoporotic . Analyses of Receiver Operating Characteristic (ROC) curves showed that AHs discriminated vertebral fractures almost perfectly (AUC 0.97; 95% CI 0.95-0.99). On the other hand, the AUC for LS-BMD was only 0.73 (95% CI 0.64-0.81) and for FN-BMD was 0.72 (95%CI 0.63-0.80), showing that the diagnostic accuracy of AHs was significantly higher compared to that of LS-BMD (p<0.001) or FN-BMD (p<0.001). A modified Poisson regression model for binary data was used to assess the independent role of AHs in predicting vertebral fracture. The effect of AHs remained statistically significant (p<0.001) after adjusting by FN-BMD, age, weight and body height. CONCLUSIONS Results of this study indicate the validity of this new morphometric index in evaluating the risk of osteoporotic vertebral fractures thus suggesting that AHs should be considered a valid parameter in clinical practice to assess the need for primary prevention of vertebral fractures.
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Affiliation(s)
- D Diacinti
- Department of Radiology, University La Sapienza, Rome, Italy
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Sperling EA, Robinson JM, Pisani D, Peterson KJ. Where's the glass? Biomarkers, molecular clocks, and microRNAs suggest a 200-Myr missing Precambrian fossil record of siliceous sponge spicules. Geobiology 2010; 8:24-36. [PMID: 19929965 DOI: 10.1111/j.1472-4669.2009.00225.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The earliest evidence for animal life comes from the fossil record of 24-isopropylcholestane, a sterane found in Cryogenian deposits, and whose precursors are found in modern demosponges, but not choanoflagellates, calcareans, hexactinellids, or eumetazoans. However, many modern demosponges are also characterized by the presence of siliceous spicules, and there are no convincing demosponge spicules in strata older than the Cambrian. This temporal disparity highlights a problem with our understanding of the Precambrian fossil record--either these supposed demosponge-specific biomarkers were derived from the sterols of some other organism and are simply retained in modern demosponges, or spicules do not primitively characterize crown-group demosponges. Resolving this issue requires resolving the phylogenetic placement of another group of sponges, the hexactinellids, which not only make a spicule thought to be homologous to the spicules of demosponges, but also make their first appearance near the Precambrian/Cambrian boundary. Using two independent analytical approaches and data sets--traditional molecular phylogenetic analyses and the presence or absence of specific microRNA genes--we show that demosponges are monophyletic, and that hexactinellids are their sister group (together forming the Silicea). Thus, spicules must have evolved before the last common ancestor of all living siliceans, suggesting the presence of a significant gap in the silicean spicule fossil record. Molecular divergence estimates date the origin of this last common ancestor well within the Cryogenian, consistent with the biomarker record, and strongly suggests that siliceous spicules were present during the Precambrian but were not preserved.
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Affiliation(s)
- E A Sperling
- Department of Geology and Geophysics, Yale University, New Haven, CT, USA
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Rocchietti March M, Pisani D, Aliberti G. Male osteoporosis. MINERVA ENDOCRINOL 2009; 34:325-332. [PMID: 20046161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Osteoporosis is a worldwide major public health problem, defined as "a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility and susceptibility to fractures". Osteoporosis is diagnosed by bone mineral density measurement (T-score of -2.5 or below) also in men. However, most of the studies carried out in the last decade focused on pathogenesis, diagnosis and treatment of osteoporosis in women. In spite of this, recent epidemiological and observational studies have shown that osteoporosis in men is an increasingly important clinical issue. In part because the world population is aging, it is likely that the total number of hip fractures in men in 2025 will be similar to current estimates in women. Furthermore 25-33% of men in some populations will sustain osteoporotic fractures in their lifetime. Nevertheless, male osteoporosis is still underdiagnosed and further studies are required to clarify the pathogenesis and find out the right therapy. Prevention and early diagnosis are, nowadays, the best ways of treatment.
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Abstract
AbstractWell-supported molecular phylogenies, combined with knowledge of modern biology, can lead to new inferences about the sequence of character acquisition in early animal evolution, the taxonomic affinity of enigmatic Precambrian and Cambrian fossils, and the Proterozoic Earth system in general. In this paper we demonstrate, in accordance with previous molecular studies, that sponges are paraphyletic, and that calcisponges are more closely related to eumetazoans than they are to demosponges. In addition, our Bayesian analysis finds the Homoscleromorpha, previously grouped with the demosponges, to be even more closely related to eumetazoans than are the calcisponges. Hence there may be at least three separate extant ‘poriferan’ lineages, each with their own unique skeleton. Because spiculation is convergent within ‘Porifera’, differences between skeletonization processes in enigmatic Cambrian taxa such as Chancelloria and modern sponges does not mean that these Problematica are not organized around a poriferan body plan, namely a benthic, sessile microsuspension feeding organism. The shift from the anoxic and sulphidic deep ocean that characterized the mid-Proterozoic to the well-ventilated Phanerozoic ocean occurs before the evolution of macrozooplanton and nekton, and thus cannot have been caused by the advent of faecal pellets. However, the evolution and ecological dominance of sponges during this time interval provides both a mechanism for the long-term generation of isotopically-light CO2 that would be recorded in carbon isotopic excusions such as the ‘Shuram’ event, and an alternative mechanism for the drawdown and sequestration of dissolved organic carbon within the sediment.
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Affiliation(s)
- E. A. Sperling
- Department of Geology and Geophysics, Yale University, P.O. Box 208109, New Haven, CT 06520, USA
| | - D. Pisani
- Laboratory of Evolutionary Biology, The National University of Ireland, Maynooth, County Kildare, Ireland
| | - K. J. Peterson
- Department of Biological Sciences, Dartmouth College, Hanover, NH 03755, USA (e-mail: )
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15
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Braucci S, Trappolini F, Angrisani L, Luberti E, Clarice A, Proietta M, Pisani D, Trappolini M. [Ulcerative colitis and thrombocytopenia: a clinical case of fortuitous association?]. Clin Ter 2007; 158:27-30. [PMID: 17405657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Ulcerative colitis (UC) is an inflammatory bowel disease of unknown etiology, involving primarily the rectum with major intestinal symptoms. Additionally, UC is often associated with extraintestinal manifestations, especially arthropathies, as well as with some autoimmune disorders. Vice versa, UC is rarely described in association with hematologic abnormalities, such as autoimmune hemolytic anemia and immune thrombocytopenic purpura with antiplatelet antibodies positive. Usually UC precedes the onset of thrombocytopenia by days or years or coincides with it. We report a case of UC and thrombocytopenia with negative anti-platelet antibodies in which an immunosuppressive therapy with corticosteroids obtained significant remission of intestinal symptoms along with a rapid increase of platelet count.
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Affiliation(s)
- S Braucci
- Dipartimento di Medicina Interna, Ospedale Sant'Andrea, II Facoltui di Medicina, Università di Roma La Sapienza, Roma, Italia
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16
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Del Piñal F, García-Bernal FJ, Delgado J, Regalado J, Pisani D, Sanmartín M. Técnica para el tratamiento de la malunión intra-articular del radio mediante osteotomías con control artroscópico. Rev Iberoam Cir Mano 2005. [DOI: 10.1055/s-0037-1606676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
El propósito de este trabajo es presentar un método para realizar las osteotomías intraarticulares con control visual.
Método: Utilizamos los abordajes dorsales clásicos de artroscopia (3-4, 6-R) además de un portal volar radial (VR). Para visualizar la articulación radiocarpiana recurrimos sólo a la tracción sin irrigar con agua. Las osteotomías se efectuaron con osteotomos de 4 mm introducidos por los portales y bajo control visual por la óptica del artroscopio. Una vez finalizada la refractura se movilizaron y fijaron los fragmentos desplazadas mediante tornillos o placas, obteniendo en todos los casos escalones próximos a 0mm.
Conclusiones: Este procedimiento permite realizar la partición de los fragmentos por los trazos originales de fractura. La clave de esta intervención es realizar la artroscopia sin agua (técnica seca) que permite una visión nítida y la ejecución de las osteotomías sin extravasación de agua, ni pérdidas de visión.
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Affiliation(s)
- F. Del Piñal
- Instituto de Cirugía Plástica y de la Mano. Medicina Privada y Hospital Mutua Montañesa. Santander. España
| | - F. J. García-Bernal
- Instituto de Cirugía Plástica y de la Mano. Medicina Privada y Hospital Mutua Montañesa. Santander. España
| | - J. Delgado
- Instituto de Cirugía Plástica y de la Mano. Medicina Privada y Hospital Mutua Montañesa. Santander. España
| | - J. Regalado
- Instituto de Cirugía Plástica y de la Mano. Medicina Privada y Hospital Mutua Montañesa. Santander. España
| | - D. Pisani
- Médico Visitante. Servicio de Cirugía de la Mano (Prof. G. Pajardi). Hospital Multimédica. Universidad de milán. Italia
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17
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Abstract
Cope's rule is the tendency for body size to increase over time along a lineage. A set of 65 phylogenetically independent comparisons, between earlier and later genera, show that Cope's rule applied in dinosaurs: later genera were on average about 25% longer than the related earlier genera to which they were compared. The tendency for size to increase was not restricted to a particular clade within the group, nor to a particular time within its history. Small lineages were more likely to increase in size, and large lineages more likely to decrease: this pattern may indicate an intermediate optimum body size, but can also be explained as an artefact of data error. The rate of size increase estimated from the phylogenetic comparisons is significantly higher than the rate seen across the fauna as a whole. This difference could indicate that within-lineage selection for larger size was opposed by clade selection favouring smaller size, but data limitations mean that alternative explanations (which we discuss) cannot be excluded. We discuss ways of unlocking the full potential usefulness of phylogenies for studying the dynamics of evolutionary trends.
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Affiliation(s)
- D W E Hone
- Department of Biological Sciences, Imperial College London, Ascot, UK.
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18
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Mazzuoli G, Marinucci D, D'erasmo E, Acca M, Pisani D, Rinaldi MG, Bianchi G, Diacinti D, Minisola S. Cyclical behavior of bone remodeling and bone loss in healthy women after menopause: results of a prospective study. Bone 2002; 31:718-24. [PMID: 12531568 DOI: 10.1016/s8756-3282(02)00901-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Annual changes in lumbar bone mineral density (LBMD) and bone remodeling markers were measured in 238 healthy pre- and postmenopausal women, aged 45-74 years. The subjects were divided into groups according to their menstrual status and years since menopause. The results obtained indicate that bone loss is not a constant process over time but rather exhibits cyclical damping oscillations. When the log-linear trend of LBMD decrement was transformed into a constant by considering annual percentage changes, the presence of a cyclical component of 7 years was evident. By employing a harmonic regression model, the cyclical component was also statistically significant on baseline data. The cyclical behavior of LBMD decrement corresponded to an analogous behavior of the bone remodeling markers. These results suggest that a lack of estrogen acts as a synchronizer on bone remodeling by triggering a latent cyclical rhythm of bone loss that persists throughout life after menopause. The existence of a chronobiological rhythm of bone loss starting after menopause, if confirmed, could have important clinical implications.
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Affiliation(s)
- G Mazzuoli
- Dipartmento Scienze Cliniche, Università delgi studi di Roma La Sapienza, Italy.
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19
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Pugliese R, Maggioni D, Berardi V, Scandroglio I, Pisani D, Mariani A, Di Lernia S, Valli C, Cocotta E. Extended (D2) lymphadenectomy in gastric cancer: a five year experience. Int Surg 2000; 85:209-15. [PMID: 11324997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
The extent of lymph node dissection in stomach adenocarcinoma is currently under debate. Japanese data strongly support the therapeutic value of extended lymphadenectomy (D2 node dissection), whereas in Western countries several prospective trials have recently been completed with contrasting results. During the period May 1993 to May 1998, 164 patients with gastric cancer were observed: 136 patients, treated with a radical surgical procedure including lymph node dissection according to the guidelines of the Japanese Research Society for Gastric Cancer, were eligible for our analysis. Clinical, histopathological, and surgical factors were examined for their influence on long-term survival. Our results on morbidity and mortality rates are similar to Japanese series: we suggest that the experience and training of the surgeon and his personal attitude towards extensive lymph node dissection may, therefore, be a major factor influencing the morbidity associated with the procedure. The relatively high estimated 3-year survival rate (52%) suggests support for extended lymphadenectomy (D2 dissection) in gastric cancer as standard treatment.
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Affiliation(s)
- R Pugliese
- Department of General Surgery, Niguarda Hospital, Milan, Italy
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20
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Mazzuoli G, Acca M, Pisani D, Diacinti D, Scarda A, Scarnecchia L, Pacitti MT, D'Erasmo E, Minisola S, Bianchi G, Manfredi G. Annual skeletal balance and metabolic bone marker changes in healthy early postmenopausal women: results of a prospective study. Bone 2000; 26:381-6. [PMID: 10719282 DOI: 10.1016/s8756-3282(00)00242-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to establish the duration and annual rate of menopause-related bone loss and to investigate the relationship between bone turnover and bone loss in early healthy postmenopausal women. The rate of change in bone mineral density (BMD) at the lumbar spine and in bone turnover was measured twice at the exact interval of 12 months by dual-energy X-ray absorptiometry (DXA) and by the determination of plasma alkaline phosphatase levels (ALP) and fasting urinary hydroxyproline/creatinine ratio (OHPr/Cr), respectively, in 123 healthy premenopausal and postmenopausal women 45-60 years of age. The subjects were divided into nine groups according to their menstrual status and years since menopause (YSM). Annual bone loss at the lumbar spine of women who were menopausal for 1, 2, 3, 4, and 5 years was -2.62 +/- 0.37 (95% confidence interval -3.66, -1.58), -3.87 +/- 0.96 (-6.02, -1.73), -2.50 +/- 0. 37 (-3.29, -1.70), -2.86 +/- 0.73 (-4.44, -1.27), and -1.54 +/- 0.41 (-2.42, -0.66), respectively, and was significantly less than zero. But, the annual bone loss of women who were premenopausal or menopausal for 6, 7, and 8 years was -0.76 +/- 0.60 (-2.04, +0.53), -1.16 +/- 0.68 (-2.61, +0.29), 0.24 +/- 0.48 (-0.78, +1.26), and 0. 16 +/- 0.63 (-1.18, -1.49), respectively, and was not significantly different from zero. These results demonstrate that the early hormone-dependent bone loss commences in the first year after menopause and is arrested within 6 years after the onset of menopause. The overall bone loss for this phase is estimated to be approximately 15%. Annual change in ALP and OHPr/Cr seems to indicate that bone resorption prevails on bone formation in the first 2 YSM, whereas osteoblastic activity relatively prevails from YSM 3 to YSM 5, which explains the progressive repairing of the imbalance between bone resorption and formation.
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Affiliation(s)
- G Mazzuoli
- II Clinica Medica, Università "La Sapienza,", Rome, Italy.
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21
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D'Erasmo E, Pisani D, Romagnoli S, Ragno A, Acca M. Acute serum calcium changes in transient ischemic attack and cerebral infarction. J Med 1999; 29:331-7. [PMID: 10503167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Total (T-Ca), albumin corrected (A-Ca) and ionized (Ca++) serum calcium levels were measured in patients affected by transient ischemic attack (TIA) and ischemic cerebral infarction (ICI), in order to evaluate the clinical and prognostic significance of calcemic status during the acute phase of these events. These results demonstrate that the calcium level is decreased in cerebral ischemia and that more substantial changes are observed in ICI than in TIA and controls (p < 0.0001, p < 0.02 and p < 0.0001 respectively for T-Ca, A-Ca and Ca++; analysis of variance). The mean T-Ca was significantly reduced in patients who died during hospitalization compared with values observed in survivors (p < 0.005), whereas A-Ca and Ca++ were not different. The calcium changes observed in the early phase of TIA and ICI suggest that the severity of cerebral ischemia may condition the amount of its acute decrease. The cause of hypocalcemia is unclear (primary effect or secondary epiphenomenon of cerebral ischemia?), but when A-Ca and Ca++ are considered, its in-hospital unfavorable prognostic role may be excluded.
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Affiliation(s)
- E D'Erasmo
- IIo Clinica Medica, Università La Sapienza, Roma, Italia.
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22
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D'Erasmo E, Pisani D, Ragno A, Raejntroph N, Letizia C, Acca M. Relationship between serum albumin and bone mineral density in postmenopausal women and in patients with hypoalbuminemia. Horm Metab Res 1999; 31:385-8. [PMID: 10437629 DOI: 10.1055/s-2007-978760] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Some discrepancies exist about the relationship between serum albumin level and the pathogenesis of osteoporosis; moreover, most of the studies available have especially concerned patients with osteoporosis, often associated with fractures. Our study, therefore, aims to investigate the presence of a relationship between serum albumin level and bone mineral density in a group of healthy women (n=650; mean age 59.0 +/- 7.4 years) who voluntarily underwent screening for osteoporosis only because they were menopausal (11.2 +/- 7.4 years since menopause) and, for comparison, in a group of outpatients (n = 44; mean age 57.6 +/- 7.0 years; 9.1 +/- 6.7 years since menopause) with hypoalbuminemia associated with diseases. The results show a lack of any relationship in healthy women between serum albumin value and bone mineral density; the lack of correlation was also shown when the postmenopausal women were down into normal, osteopenic and osteoporotic (WHO criteria) or in hypo, normal and hyperalbuminemic. The only significant parameters associated with lower bone mineral density, in fact, were age and years since menopause (p<0.0001 and p<0.0001 respectively at lumbar spine and p<0.02 and p<0.001 at femoral neck level). In the group of patients with hypoalbuminemia associated with diseases, on the other hand, a relationship between reduced bone mineral density and hypoalbuminemia was found (p<0.01 and p<0.05 respectively at lumbar spine and femoral neck). In conclusion, in healthy postmenopausal women the serum albumin level does not play a significant role in the pathogenesis of bone density reduction, which is mainly due to the number of years since menopause and advancing age. The hypoalbuminemia may be related to the reduction of bone mass only in the subjects affected by diseases associated with a significant albumin reduction.
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Affiliation(s)
- E D'Erasmo
- II Clinica Medica, Policlinico Umberto I, Università La Sapienza, Roma, Italia.
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23
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Abstract
It has been demonstrated that in healthy subjects during oral glucose tolerance test, serum calcium declines, while urinary calcium excretion increases, even if there is not a general agreement in this regard. The study was carried out in order to evaluate the effects of glucose oral load on calcium homeostasis in eight healthy adult women, also considering ionized calcium, plasma insulin and parathyroid hormone changes. The results showed a decline of total and ionized serum calcium (p < 0.05 and p < 0.01, respectively; maximum of the decrease at time 120'), in parallel with the increase of urinary calcium/ creatinine ratio (p < 0.05). Serum glucose and insulin increase (p < 0.0001 and p < 0.0005 respectively; maximum value at time 60'), while the parathyroid hormone level decreases (maximum decline at time 120', p < 0.01). No changes were observed in fasting control subjects for all parameters considered. The changes of these parameters with time suggest that the effects of glucose oral load on calcium metabolism in healthy adult women may be the consequence of parathyroid hormone suppression induced by acute hyperglycemia/hyperinsulinemia. The results confirm in vivo the PTH behaviour in vitro, on cultured bovine parathyroid cells, with high glucose concentration.
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Affiliation(s)
- E D'Erasmo
- II Clinica Medica, Policlinico Umberto I, Università La Sapienza, Roma, Italia.
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24
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Cioffi U, De Simone M, Pavoni G, Poggi L, Pisani D, Ferrero S, Santambrogio L. Pulmonary capillary hemangiomatosis in an asymptomatic elderly patient. Int Surg 1999; 84:168-70. [PMID: 10408291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
Thoracic hemangiomatosis is an extremely rare condition of the thorax of unknown origin: thin-walled capillary blood vessels infiltrate the lung parenchyma, blood vessels, interlobular septa, bronchiolar walls and pleura. The infiltration of pulmonary veins and venules induces secondary pulmonary veno-occlusive disease and pulmonary hypertension with a slowly progressive clinical course. This condition can be associated with vascular dementia and disseminated intravascular coagulation (DIC).
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Affiliation(s)
- U Cioffi
- Department of General and Thoraic Surgery, Ospedale Maggiore Policlinico, IRCCS, University of Milan, Italy
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25
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D'Erasmo E, Pisani D, Romagnoli S, Ragno A, Acca M. Clinical and prognostic significance of hyperfibrinogenemia in cerebral ischemia. J Med 1998; 29:115-23. [PMID: 9865453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
In order to evaluate the clinical and prognostic significance of early hyperfibrinogenemia in patients with transient ischemic attack (TIA) and ischemic cerebral infarction (ICI), we analyzed the relationships between plasma fibrinogen, brain damage severity, clinical status on admission and intra-hospital mortality. Vascular damage severity was estimated by measuring the necrotic area by computed axial tomography (CT) and indirectly by means of changes in some plasma enzymes (CK, LDH, GPT/ALT, and GOT/AST). Plasma fibrinogen levels were statistically higher in ICI than in TIA and control subjects (p < 0.0005; analysis of variance). Moreover, plasma fibrinogen was directly related to the extension of the necrotic area at CT scan (p < 0.05) and in ICI patients was positively correlated with CK (r = 0.50, p < 0.01), LDH (r = 0.41, p < 0.05) and GOT/AST (r = 0.42, p < 0.05) serum levels, but not with GPT/ALT. A higher plasma fibrinogen value was observed in patients with stupor or coma compared with those with alert consciousness (p < 0.05). In patients who died during hospitalization, fibrinogen levels were higher than those of subjects who were discharged (p < 0.005). The results indicate that in the early phase of cerebral ischemia, plasma fibrinogen levels are related to the severity of the clinical status and to the extension of the brain vascular damage, thus representing a negative clinical and prognostic factor of the disease.
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Affiliation(s)
- E D'Erasmo
- II Clinica Medica, Policlinico Umberto I, Università La Sapienza, Rome, Italy
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26
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D'Erasmo E, Ragno A, Raejntroph N, Pisani D. [Drug-induced osteomalacia]. Recenti Prog Med 1998; 89:529-33. [PMID: 9842257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The osteomalacia is a metabolic bone disease, characterized by a defect of bone mineralization, due to a lot of causes; among these an important role may be attributed to some drugs. The drugs most frequently associated with osteomalacia are: cholestyramine, phenytoin, phenobarbital, rifampicin, isoniazid, aluminium-containing antacid, saccharated ferric oxide, cadmium, lead, bisphosphonates, fluoride and aluminum. In this review we discuss about the pathophysiologic mechanisms related to drug-induced osteomalacia involving vitamin D metabolism, phosphorus homeostasis and bone mineralization.
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Affiliation(s)
- E D'Erasmo
- Cattedra di Medicina Interna, Policlinico Umberto I, Università La Sapienza, Roma
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27
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Abstract
The aim of this study was to investigate the correlation between lumbar spine bone mineral density (LS-BMD) and the vertebral body heights with advancing age and years since menopause. One hundred and sixty-three women ages 39-74 years (77 normal premenopausal, ages 39-54, and 86 normal postmenopausal, ages 46-74 years) were studied. LS-BMD was measured by dual energy X-ray absorptiometry. Vertebral heights were evaluated, using morphometry, as the sum of anterior (AHs), middle (MHs), and posterior (PHs) vertebral body heights from T4 to L5. The AHs/PHs ratio at the same level was also calculated. AHs, MHs, PHs, and AHs/PHs ratio directly correlated with LS-BMD; the correlations are AHs r = 0.80, P < 0.0001, MHs r = 0.75, P < 0.0001, PHs r = 0.76, P < 0.0001, and AHs/PHs r = 0.66, P < 0.001. Both LS-BMD and AHs are inversely correlated with age, and the regressions fit with both linear and cubic curves. The statistical significance of the correlations persists while maintaining age constant. The linear regression curve of AHs with age indicates that the spine height decrement rate is 2.12 mm/year, corresponding to 7.4 cm in 35 years. AHs decreases immediately after menopause fitting with a cubic curve model, with a decrement rate of about 3 cm in the first 5 years after menopause. We conclude that the measurement of the sum of vertebral body heights could usefully integrate LS-BMD evaluation in the clinical and epidemiological investigation of osteoporosis.
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Affiliation(s)
- G F Mazzuoli
- Istituto II Clinica Medica, Policlinico Umberto I, University of Rome "La Sapienza," 00161 Rome, Italy
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28
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Abstract
Primary hyperparathyroidism (PHPT) is considered a cause of secondary osteoporosis as a consequence of its known catabolic effect promoting osteoclast activity and bone resorption. However, recent in vitro and in vivo studies have shown that parathyroid hormone (PTH) may also have an anabolic effect on the mammalian skeleton. These two paradoxical effects of parathyroid hormone are discussed in the light of recent results of basic research, and of bone densitometric and histomorphometric data collected in patients affected by PHPT. Review of the literature leads to the conclusion that in PHPT skeletal damage involves prevalently cortical bone, while the mineral content of trabecular bone is preserved or even increased. On the basis of bone mineral density (BMD) measurements, osteoporosis prevalence in the early postmenopausal period seems to be significantly higher in women affected by PHPT than in the general population. As age progresses, osteoporosis prevalence seems to decrease in PHPT, while it increases exponentially with age in the general population. Similarly in PHPT, vertebral and appendicular fractures occur prevalently in the earlier decades of life with a higher frequency than in normal subjects, while with advancing age the fracture incidence becomes equal to that of the general population. When bone density is measured in lateral projection at lumbar level, BMD values in patients with mild asymptomatic PHPT are significantly higher than in controls. We conclude that PTH hypersecretion may represent a risk factor for osteoporosis and fractures in the young and in the early postmenopausal period, while it may have a protective effect on trabecular bone in elderly postmenopausal women.
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Affiliation(s)
- G F Mazzuoli
- II Clinica Medica, Policlinico Umberto I, La Sapienza University, Roma, Italy
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29
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Minisola S, Pacitti MT, Rosso R, Pellegrino C, Ombricolo E, Pisani D, Romagnoli E, Damiani C, Aliberti G, Scarda A, Mazzuoli SF. The measurement of urinary amino-terminal telopeptides of type I collagen to monitor bone resorption in patients with primary hyperparathyroidism. J Endocrinol Invest 1997; 20:559-65. [PMID: 9413811 DOI: 10.1007/bf03348019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study was carried out in order to evaluate clinical usefulness of cross-linked N-telopeptides (NTx) of type I collagen determination, in patients with primary hyperparathyroidism. Twenty-six consecutive patients (6 males and 20 females, aged 56.3 +/- 15.0, SD, yrs) with primary hyperparathyroidism were studied in basal conditions and, ten of them, after surgical cure of the disease. Cross-linked collagen peptides were measured by enzyme-linked immunosorbent assay and conventional markers of bone turnover according to standard procedures. Bone densitometry at the lumbar spine and proximal femur was performed using dual-energy X-ray absorptiometry. Bone mineral density, was also assessed at the junction of the distal and middle third of the radius and at the ultradistal radius of the non-dominant arm by a dual photon densitometer. Mean urinary NTx values (194.2 +/- 121.9 pmoles bone collagen equivalents/mumoles creatinine) were significantly higher (p < 0.001) in respect to those found in normal subjects. The mean increase of Z score values of both serum tartrate resistant acid phosphatase activity (1.4 +/- 1.8) and the fasting hydroxyproline/creatinine ratio (1.45 +/- 2.0) was significantly lower (p < 0.02) in respect to that of NTx Z score values (3.3 +/- 3.3); the latter values were not significantly different than mean Z score values of serum osteocalcin (4.0 +/- 3.9), serum alkaline phosphatase activity (2.6 +/- 2.6) and urinary calcium/creatinine ratio (3.2 +/- 3.3). We found a significant inverse correlation between NTx values and both lumbar spine (p < 0.01) and ultradistal radius bone mineral density (p < 0.05); a modest inverse correlation was also observed between serum tartrate resistant acid phosphatase activity and lumbar spine bone mineral density (p < 0.04). Following successful adenoma removal, the percentage decrease of both NTx and hydroxyproline was similar in patients with increased bone turnover rate; major discrepancies were observed in patients with normal values of NTx, the telopeptide reduction being greater than that of hydroxyproline. Finally, in a hypercalcemic patient with metastatic parathyroid cancer, telopeptide excretion was shown to be more sensitive in respect to urinary hydroxyproline when evaluating the effects of antiresorptive therapy. Our results seem to indicate that amongst the markers with good sensitivity, NTx is the only one that is inversely related with bone mineral density at two different skeletal sites. This assay should therefore have a place in both the initial screening and medical follow-up of patients with this glandular disorder; in fact, in both situations an increased urinary excretion of this marker should warn about the possibility of hidden bone loss.
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Affiliation(s)
- S Minisola
- Cattedra di Medicina Interna 4, Università di Roma La Sapienza, Italy
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30
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Abstract
We evaluated serum albumin at time of admission, within 72 hours, in 135 geriatric patients who were older than 70 years to establish its role as a predictor of death and clinical outcome at time of discharge. Serum albumin values were reduced significantly in patients who died compared with those who were discharged in unchanged/impaired and improved conditions (3.01 +/- 0.68 g/dL, 3.18 +/- 0.55 g/dL, and 3.65 +/- 0.52 g/dL respectively, P < 0.0001). A correlation between serum albumin concentration at admission and number of days elapsed from admission and death was found (r = 0.43, P < 0.05). Mortality rate was 38.6% in patients with serum albumin values < 3.3 g/dL compared with 14.1% in those with albumin values > or = 3.3 g/dL (P < 0.005). Similar results were obtained even when the main diagnostic conditions, such as cardiocerebrovascular disease and cancer, were considered. The results demonstrate that in geriatric patients the serum albumin level at admission may be a predictor of mortality and clinical outcome at discharge.
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Affiliation(s)
- E D'Erasmo
- II Clinica Medica, Università La Sapienza, Rome, Italy
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31
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Carnevale V, Romagnoli E, Remotti D, D'Erasmo E, Spagna G, Pisani D, Rosso R, Minisola S, Mazzuoli GF. Pulmonary lymphangioleiomyoma in a patient with multiple endocrine neoplasia type I. J Endocrinol Invest 1997; 20:282-5. [PMID: 9258808 DOI: 10.1007/bf03350301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The multiple endocrine neoplasia (M.E.N.) syndromes consist of a group of proliferative disorders that selectively target specific sets of endocrine and soft tissue cells. Here we report a case of lymphangioleiomyoma of the lung in a patient with multiple endocrine neoplasia Type I (M.E.N. I). This is the first time such an association has been reported. In our opinion it could possibly be ascribed to the genetic predisposition to proliferative disorders of patients with M.E.N. syndromes.
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Affiliation(s)
- V Carnevale
- Cattedra di Medicina Interna 4, Università degli Studi di Roma La Sapienza, Italy
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32
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Acca M, Pisani D, D'Erasmo E. [Calcium and bone mass at different periods of life]. Clin Ter 1994; 145:157-62. [PMID: 7955962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In this review we report some considerations on the relationships between calcium intake and bone density during life time, with particular regard to postmenopausal women. We also report some practical aspects concerning calcium salt supplementation.
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Affiliation(s)
- M Acca
- Istituto di II Clinica Medica, Università degli Studi di Roma La Sapienza
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33
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Abstract
Gamma-glutamyl transferase (GGT) serum levels were measured in 42 female patients within 72 hours, and on day 10, after an ischaemic cerebral infarction (CI) and correlated with neurological impairment at admission and with mortality during hospitalization. Mean +/- SEM GGT serum value within 72 hours after CI was significantly higher compared to the mean +/- SEM value observed in control subjects (26.7 +/- 2.5 vs 16.5 +/- 1.2 U/L, P < 0.001) and it correlated with the severity of neurological status and with mortality. A positive correlation between GGT and creatine kinase (CK) serum levels was also observed (r = 0.47, P < 0.01). On day 10 after CI, normalization of serum GGT values was found. We conclude that GGT serum level increases in CI as a consequence of brain damage and that this increment may be considered as a clinical and prognostic unfavourable index of the disease.
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Affiliation(s)
- E D'Erasmo
- Clinica Medica, University of Rome, La Sapienza, Policlinico Umberto I, Italy
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34
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D'Erasmo E, Acca M, Pisani D, Volpe MS. Neurological state, infarct size and clinical outcome are related to early platelet count decrease in stroke. Gerontology 1993; 39:276-9. [PMID: 8314094 DOI: 10.1159/000213543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
We performed this study in order to verify the existence of a correlation between early platelet count reduction and initial neurological impairment, infarct extension and mortality or clinical outcome in an established ischemic cerebral infarction. The results demonstrate that the platelet consumption and/or accumulation in the infarct area, expressed by circulating platelet decrease, is related to the severity of neurological involvement, infarct size and poor clinical outcome.
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Affiliation(s)
- E D'Erasmo
- II Clinica Medica, University of Rome La Sapienza, Italy
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35
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Gliozzi A, Paoli G, Pisani D, Gliozzi F, De Rosa M, Gambacorta A. Phase transitions of bipolar lipids of thermophilic archaebacteria. Biochimica et Biophysica Acta (BBA) - Biomembranes 1986. [DOI: 10.1016/0005-2736(86)90450-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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36
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Pritsos CA, Jensen DE, Pisani D, Pardini RS. Involvement of superoxide in the interaction of 2,3-dichloro-1,4-naphthoquinone with mitochondrial membranes. Arch Biochem Biophys 1982; 217:98-109. [PMID: 6289757 DOI: 10.1016/0003-9861(82)90483-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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37
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Pisani D, Nigro A. [Pharmacological aspecific deconditioning]. Riv Neurobiol 1970; 16:329-36. [PMID: 5518841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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38
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Kaufman A, Rodríguez Díaz LH, Niño H, Pisani D, Gelrud M, Rodríguez Duarte C, Martínez Navas F. [The usefulness of the radiological study of the renal parenchyma]. Rev Venez Urol 1970; 22:85-98. [PMID: 5497369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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39
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Pisani D, Deodato G, Nigro A. [Action of a static magnetic field on the GRS]. Riv Neurobiol 1969; 15:704-12. [PMID: 5403683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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40
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Pisani D, Ardizzone EC, Nigro A. ["Passatization" of the EEG by "blocking" of winking and of the specific afferent zone of motility]. Riv Neurobiol 1969; 15:719-24. [PMID: 5403685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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41
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Pisani D, Ardizzone EC, Nigro A. [The "pastization" of the epileptic by reflex action]. Riv Neurobiol 1969; 15:400-7. [PMID: 5386489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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42
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Pisani D, Ardizzone EC, Nigro A. [On the mechanism of the neurotic reaction]. Riv Neurobiol 1969; 15:259-318. [PMID: 5401536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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43
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Pisani D, Nigro A, Peditto G. [Significance of the cutaneous electric resistance (CER) in headache]. Riv Neurobiol 1969; 15:319-29. [PMID: 5401537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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44
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Pisani D, Di Stefano M, Nigro A. [On the influence of teleception on the index of "passatizzazione" during arrest of winking]. Riv Neurobiol 1969; 15:72-84. [PMID: 5399617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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45
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Pisani D, Nigro A, Schillaci A. [On the duration of electric contraction under the influence of music]. Riv Neurobiol 1969; 15:209-21. [PMID: 5399612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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46
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Pisani D, Vitetta M. [The neuroticizing effect of environmental factors in child psychoneuroses]. Riv Sper Freniatr Med Leg Alien Ment 1967; 91:1579-89. [PMID: 5629715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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47
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Pisani D, Gloria L, Nigro A. [Study of the electrical resistance of the skin in epileptics and neurotics. Rapid changes produced by music]. Riv Neurobiol 1967; 13:721-6. [PMID: 5605668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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48
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Pisani D, Nigro A. [Dissociation of the temporal components of consciousness as a basis of sleep and dreams]. Riv Neurobiol 1967; 13:747-62. [PMID: 5605670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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49
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Pisani D, Nigro A, Schillaci F. [Changes in the cutaneous electric resistance and diffusion of EMG potentials after regional muscular work in neurotics and epileptics]. Riv Neurobiol 1967; 13:455-70. [PMID: 5596320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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